Most people have already had a sore throat or tonsillitis (pharyngitis). These diseases may have both viral and bacterial causes. Approximately 20-30% of the cases of sore throat and tonsillitis are of bacterial origin. In any case, this involves an infection by Streptococcus pyogenes. Streptococcus pyogenes is one of the most common human pathogenic bacteria. Bacterial pharyngitis is spread by droplet infection. Children and teenagers between the ages of 5 and 15 are the group most commonly affected by this infection but the elderly are also at risk of infection in crowded human conditions (Bisno 1995). The number of S. pyogenes infections in the United States is estimated at 10 million per year (Kilian 2002). The associated costs are estimated at approx. 1 billion dollars annually in the Unites States (Reid et al. 2001). The number of acute streptococcal pharyngitis cases in Germany is estimated at 1 to 1.5 million per year. Only a portion of the infections have a clinically manifest course, i.e., the reservoir of transmitted pathogens is larger.
Streptococcus pyogenes (group A streptococci, also referred to as GAS) is a human pathogen belonging to the Gram-positive cocci that form long chains. Like many other pathogens, streptococci also have the ability to express multiple virulence factors. The first step in the course of pathogenesis of Streptococcus pyogenes is adhesion of the bacteria to the surface of the host cells. According to a widely accepted model, adhesion takes place in two stages: the first stage consists of a weak, relatively nonspecific interaction with the surface of human cells, which immediately results in a tissue-specific interaction with a high affinity (Hasty et al. 1992; Courtney et al. 1999; Cunningham 2000). As early as 1976, Beachey et al. were able to identify lipoteichoic acid (LTA) as a molecule that mediates the initial adhesion on a bacterial level. On the epithelial level, fibronectin has been identified as the receptor for LTA (Simpson and Beachey 1983). At least 11 other structures on the bacterial surface have been identified as imparting binding to the epithelial cells for the second stage of adhesion. The second step in pathogenesis due to Streptococcus pyogenes is the invasion of the bacteria into the epithelial host cells (LaPenta et al. 1994). LaPenta and colleagues have shown that GAS can infect human epithelial cells with frequencies that are sometimes higher than those of traditional intracellular human pathogens such as Salmonella or Listeria. 
Pathogenic bacteria inside a host cell have a high potential for replication, which can result in an acute infection. Survival in a dormant state may lead to renewed occurrence of bacterial infections of the mucous membranes and the epithelium, which can explain recurring infections of the oropharyngeal mucosa. Angina in particular is a recurring infection that is very often caused by GAS in children.
Streptococcus pyogenes is the etiologic agent of many acute diseases such as pharyngitis, scarlet fever, impetigo, cellulitis. Invasive toxigenic infections, such as necrotizing fasciitis, myositis and Streptococcus-induced toxic shock syndrome as well as the development of immunomediated sequelae such as rheumatic fever and glomerulonephritis, are all caused by Streptococcus pyogenes. 
It is estimated that between 5% and 15% of the population in general are carriers of this bacterium (usually in their throats) without any signs of disease. As a component of the normal flora, Streptococcus pyogenes can cause an infection when the immune system is weakened. Colonization of tissue (e.g., the respiratory tract or skin) with Streptococcus pyogenes follows the outbreak of the disease, associated with the relevant symptoms such as a scratchy throat, a sore throat and difficulty in swallowing.
Furthermore, infections with Streptococcus pyogenes can lead to complications due to spreading of the infection to the lower respiratory tract (otitis media, sinusitis, pneumonia) or into the blood stream and to meningitis as well as infections of the bones (osteomyelitis) and the joints (arthritis).
One element in colonization is bacterial adhesion to a cell surface and/or to the mucosal surface. The bacterium has a large repertoire of adhesions which mediate the binding to cell surfaces (e.g., M protein, fibronectin-binding protein, LTA, collagen-binding protein). The interaction, i.e., binding to cell surfaces, plays an initial role in the colonization of host cells as well as in the pathogenesis of Streptococcus pyogenes. 
Accordingly, the early use of therapeutic agents for prevention and treatment are of crucial importance to reduce the total GAS microbe count and to efficiently prevent the binding, i.e., invasion of Streptococcus pyogenes. 
Therapeutic agents capable of relieving the symptoms caused by Streptococcus pyogenes in the throat area have been described in the prior art.